{"schema_version":"1","site":"https://decosa.ai","id":"nsa-idr-packet","num":"74","name":"No Surprises Act IDR packet and eligibility screen","tool_name":"Screen a claim for Federal IDR","short":"IDR packet","blurb":"For out-of-network emergency, anesthesia, radiology and pathology groups, their billing companies, and the health plans on the other side. Give it the EOB or remittance, the open negotiation notice and the supporting documents. It reads the claim facts with quotes, then screens the claim for Federal IDR: coverage, qualified service, state law, notice and consent, the 30-business-day open negotiation start, the 4-business-day initiation window, cooling-off and batching, each check with its dated rule and the business-day arithmetic. When nothing fails, it states the offer as a dollar amount and a percentage of the QPA and drafts a brief from facts it can quote; billed charges, usual and customary charges and Medicare rates are left out. A screen-only mode makes one model call. The packet is signed. A preparation aid: a person files, and a certified IDR entity decides.","status":"live","labels":{"industry":["healthcare","finance"],"job":["review","draft"],"input":["text","files"],"deploy":["selfhost"],"status":"live","output":["data","record"],"data":["phi"],"hardware":"gpu-96","licence":"permissive"},"industries":["healthcare","finance"],"runs_in":["selfhost"],"part_of":[],"built_from":["numeric-grounding","grounding","typed-judgment","signed-record"],"models":"Qwen3.8-27B","where":"Self-host for real claims (hosted demo: synthetic disputes only)","hardware":"1x RTX PRO 6000 (96 GB) for Qwen3.8-27B; the clocks, the screen from structured facts and the signed packet need no GPU","final_artifact":"An eligibility screen with each check's rule and arithmetic, the facts with quotes, the offer as a percentage of the QPA, a checked brief when nothing fails, a Markdown packet and a signed record.","self_host_first":true,"verification":{"receipt_coverage":"full","summary":"Receipt per model call; every fact's quote found word for word with its date or amount on the line; every brief sentence grounded; signed hash-chained packet","manual_qa":{"hosted":{"date":"2026-09-27","result":"pass","p50_ms":52100,"p95_ms":null,"runs":null,"receipts_per_run":23,"cost_per_run_usd":0.0199},"selfhost":{"date":"2026-09-27","result":"pass","method":"fresh clone of decosa-api into a clean directory on our server, api image built from docker/api/Dockerfile, compose api service with a named data volume, direct route, local signing; torn down after","notes":"The assembly prompt's smoke tests passed against the already-running local Qwen3.8-27B vLLM (network_mode host instead of the compose llm service): window 2026-10-06 to 2026-10-09, the late case failed on initiation with no model, er-anesthesia-pa likely eligible with a brief at 198.48% of the QPA in 20 s (23 attested receipts), late-initiation-az and plan-consent-defense likely ineligible with no brief, record verified; the rehearsal bundle passed 15/15. Model-server startup was not re-run."},"known_limits":["Hosted verification ran on the pre-release server (decosa-api the pre-release branch on our server, gateway route). The production API gets this tool when the branch merges.","Measured on 91 synthetic, templated disputes written by the building agent; not on real remittances or against CMS's recorded eligibility outcomes.","State law comes from CMS's chart (state information current as of 11 Jan 2023); a state-regulated plan in one of the 21 listed states is marked needs review unless the file says whether the state law applies.","The pre-1 Nov 2026 similar-condition batching test is left to the certified IDR entity; the CPT section ranges for the 2026 test are our approximation (the guidance was not found).","The 2026 final rule's new portal steps are not modelled yet; the clocks will need an update when the Departments announce them."],"nightly_covers":null},"nightly":"https://api.decosa.ai/verify/status"},"eval_summary":{"metrics":[{"name":"Eligibility verdict right from documents, held out","value":"61 of 61","unit":null,"n":61,"split":"test","note":"One model call per case reads every fact; split fixed before any run and run once; templated synthetic documents"},{"name":"Planted ineligible disputes caught on the planted check","value":"32 of 32","unit":null,"n":32,"split":"test","note":"17 kinds: late or missing negotiation, early or late initiation, state law, opt-in, consent, public coverage, ground ambulance, in network, coverage denial, cooling-off, four batching faults"},{"name":"Eligible disputes passed, including traps","value":"29 of 29","unit":null,"n":29,"split":"test","note":"Traps: ancillary consent, self-insured in state-law states, day-30 and day-34 boundaries, a moved cooling-off window, air ambulance"},{"name":"Facts read right from the documents","value":"496 of 497","unit":null,"n":497,"split":"test","note":"The miss: an issue date read as the receipt date; the verdict was still right"},{"name":"Eligibility, rules only with full facts","value":"91 of 91","unit":null,"n":91,"split":"synthetic","note":"No model; gold clocks from a separate numpy implementation"},{"name":"Planted unsupported brief sentences removed","value":"25 of 25","unit":null,"n":25,"split":"synthetic","note":"Written once before the run; 22 of 22 supported sentences kept"},{"name":"Clock comparisons agreeing with a second implementation","value":"160,000 of 160,000","unit":null,"n":160000,"split":"synthetic","note":"20,000 random dates, 8 clocks, 2022-2027"}],"dataset":"91 synthetic disputes from scripts/idr_eval_cases.py (seed 74): dev 30, test 61; three hand-written briefs with 25 planted sentences; 20,000 random dates for the clocks. All CC0.","held_out":true,"caveats":["Synthetic, templated documents with one fact per line, written by the same author as the rules and prompts; real remittances, scanned EOBs and letters are harder. These numbers do not predict accuracy on real claim files.","The rules score shows the code matches the author's reading of 45 CFR 149.510 and CMS guidance, not that the reading is right; it was not checked against CMS's recorded eligibility outcomes.","The planted-sentence set is small (47 sentences) and the planted errors are the obvious kind.","The extraction prompt was adjusted on the demo samples before the dev run; distractor dates were added after the first dev run; test was run once."],"date":"2026-09-27","doc_url":"https://decosa.ai/metrics/evals/nsa-idr-packet"},"stack":{"summary":"For out-of-network emergency, anesthesia, radiology and pathology groups, their billing companies, and the health plans on the other side. Give it the remittance or EOB, the open negotiation notice and the supporting documents. It reads the claim facts with quotes found word for word, then screens the claim for the Federal IDR process: coverage type, qualified service, state law, notice and consent, the 30-business-day open negotiation start, the 4-business-day initiation window, cooling-off periods and batching, each check with its dated rule and the arithmetic. When nothing fails, it gathers the evidence for each factor the arbiter must consider, states the offer as a dollar amount and a percentage of the QPA, and drafts a brief whose sentences are each checked against the documents; lines about billed charges, usual and customary charges or Medicare rates are left out by rule. Sealed in a signed, hash-chained packet. A preparation aid: a person files, and a certified IDR entity decides.","tagline":"The EOB and notices in; a Federal IDR eligibility screen with the business-day arithmetic, and an offer brief built only from checked facts.","deployment":"self-host-first","regulatory_note":"EOBs and clinical records are protected health information under HIPAA: run it on your own hardware; the hosted demo takes synthetic disputes only. Rules read on 27 Sep 2026 from primary sources. 45 CFR 149.510 (eCFR, current to 24 Sep 2026): open negotiation within 30 business days of receiving the initial payment or denial ((b)(1)); initiation in the 4 business days starting on business day 31 of negotiation ((b)(2)(i)); no IDR after a valid notice-and-consent waiver ((b)(2)(ii)), which never covers ancillary services (149.420(b)); a 90-calendar-day cooling-off period after a determination ((c)(4)(vi), text in force before 3 Aug 2026). The Federal IDR Operations final rules (91 FR 33900, 4 Jun 2026, effective 3 Aug 2026; correction 91 FR 55462, 28 Aug 2026) apply in stages: the $15 administrative fee to disputes initiated on or after 11 Jun 2026; the new batching rules (at most 50 line items, three similar-condition tests, a 30-business-day batched cooling-off) to negotiations starting on or after 1 Nov 2026 (CMS notice, 3 Aug 2026); the new open negotiation, initiation and registry steps only 90 days after the Departments announce each IDR Gateway function (expected from Spring 2027), so until then the earlier text applies (149.510(h)). State law: CMS's applicability chart (state information current as of 11 Jan 2023) and each state's enforcement letter. Courts: TMA II (5th Cir., 2 Aug 2024) affirmed striking the rule on how arbiters weigh the QPA; TMA III (5th Cir. en banc, 11 Aug 2026) held that ghost rates may not be counted in the QPA and incentive payments may not be left out; CMS said guidance would follow (13 Aug 2026). TMA I and TMA IV are described from CMS guidance (opinions not read). It does not recompute QPAs, read state statutes or file anything. Not legal advice, and it never predicts an outcome.","components":[{"id":"llm","role":"Reads the claim facts from the EOB, remittance and notices (each with a quote), gathers the evidence for each factor the arbiter must consider, drafts the offer brief, and judges every brief sentence (the grounding judge)","name":"Qwen3.8-27B (NVIDIA NVFP4)","hf_repo":"nvidia/Qwen3.8-27B-NVFP4","license":"Apache-2.0","params":"27.8B","quant":"NVFP4 (MLP) + FP8 (attention/GDN), FP8 KV cache, MTP speculative decoding k=3","vram_gb":57,"memory_gb_estimate":null,"engine":"vLLM 0.29.0","receipt_coverage":"strong","in_hosted_demo":true,"tiers":["standard"],"alternative_to":null},{"id":"llm-lite","role":"Lite tier: the same pipeline on a 48 GB card","name":"Gemma 4 26B A4B (instruction-tuned)","hf_repo":"google/gemma-4-26B-A4B-it","license":"Apache-2.0 (model card also links the Gemma 4 licence page)","params":"25.2B","quant":"BF16 weights; FP8 at load time (vLLM --quantization fp8) to fit a 48 GB card","vram_gb":null,"memory_gb_estimate":null,"engine":"vLLM 0.29.0 (Gemma4ForConditionalGeneration is in its model registry)","receipt_coverage":"none","in_hosted_demo":false,"tiers":["lite"],"alternative_to":null},{"id":"llm-best","role":"Best tier: a larger model for long files and dense correspondence","name":"DeepSeek-V4-Flash (NVIDIA NVFP4)","hf_repo":"nvidia/DeepSeek-V4-Flash-NVFP4","license":"MIT","params":"284B","quant":"NVFP4 experts + FP8 (about 159-176 GB of weights)","vram_gb":192,"memory_gb_estimate":null,"engine":"vLLM B12X community build, TP2 on 2x RTX PRO 6000, MTP draft fixed by the kit's patches","receipt_coverage":"none","in_hosted_demo":false,"tiers":["best"],"alternative_to":null},{"id":"glm-wanted","role":"Second judge, from another family","name":"GLM-5.3-Flash","hf_repo":"zai-org/GLM-5.3-Flash","license":"MIT","params":"321B","quant":"NVFP4 on NVIDIA (nvidia/GLM-5.3-Flash-NVFP4, about 170-186 GB, unconfirmed); MLX 4-bit on a Mac (165 GB)","vram_gb":null,"memory_gb_estimate":170,"engine":"SGLang SM120 build, TP2 on 2x 96 GB (vLLM is broken on sm_120 for this model, and the SGLang build hung on our server), or mlx-lm on a Mac with 192 GB or more","receipt_coverage":"none","in_hosted_demo":false,"tiers":["wanted"],"alternative_to":null}],"tiers":[{"id":"lite","label":"Lite · one 48 GB card","summary":"The same pipeline on a smaller mixture-of-experts model. Faster and cheaper; accuracy on this task unknown.","components":["llm-lite"],"hardware":"1x L40S or RTX 6000 Ada 48 GB (not measured)","quality_evidence":[{"metric":"eligibility and brief grounding","value":"not measured yet","source":null}],"latency_note":"not measured yet","in_hosted_demo":false,"receipt_coverage":"partial","receipt_note":"Direct route: calls are attested by the box's key; no gateway receipts.","hosting":null},{"id":"standard","label":"Standard · the hosted demo, one 96 GB card","summary":"Qwen3.8-27B reads the facts, gathers the factor evidence and drafts the brief; the screen, the clocks, the offer arithmetic and the prohibited-factor rule are plain code. Every model call receipted.","components":["llm"],"hardware":"1x RTX PRO 6000 Blackwell 96 GB","quality_evidence":[{"metric":"eligibility verdict from documents alone, held-out test (61 synthetic disputes)","value":"61/61; 32/32 planted ineligible caught on the planted check; 29/29 eligible, including traps, passed","source":"decosa-api docs/evals/nsa-idr-packet.md, measured on our server 2026-09-27, gateway route; split fixed before any run; templated synthetic documents"},{"metric":"eligibility, rules only with full facts (91 planted cases)","value":"91/91; gold clocks from a separate implementation","source":"decosa-api docs/evals/nsa-idr-packet.md, measured on our server 2026-09-27"},{"metric":"facts read right from the documents (dev / test)","value":"243/243 / 496/497 (the miss: an issue date read as the receipt date)","source":"decosa-api docs/evals/nsa-idr-packet.md, measured on our server 2026-09-27"},{"metric":"planted unsupported brief sentences removed / supported sentences kept","value":"25/25 / 22/22 (changed figures, invented credentials and statistics, contradictions, moved dates, billed charges, Medicare and UCR rates)","source":"decosa-api docs/evals/nsa-idr-packet.md, measured on our server 2026-09-27; small n"},{"metric":"business-day clocks against a second implementation (numpy over the OPM holiday list)","value":"160,000/160,000 comparisons agree","source":"decosa-api docs/evals/nsa-idr-packet.md, 2026-09-27"},{"metric":"real remittances, scanned EOBs and IDR outcomes","value":"not measured yet","source":null}],"latency_note":"measured on our server under a shared gateway: a screen from documents in seconds; a full packet in under a minute to a couple of minutes (a dozen or two model calls)","in_hosted_demo":true,"receipt_coverage":"strong","receipt_note":"Hosted: gateway-signed receipt per model call. Self-hosted: attested by the box's key.","hosting":null},{"id":"best","label":"Best · DeepSeek-V4-Flash on two more cards","summary":"A larger model for long files and dense correspondence.","components":["llm-best"],"hardware":"2x RTX PRO 6000 96 GB","quality_evidence":[{"metric":"eligibility and brief grounding","value":"not measured yet","source":null}],"latency_note":"not measured yet","in_hosted_demo":false,"receipt_coverage":"partial","receipt_note":"Not a hosted model: calls are attested by the box's key only.","hosting":null},{"id":"wanted","label":"Wanted · two large judges from different families","summary":"DeepSeek-V4-Flash and GLM-5.3-Flash each read the file, and a fact or brief sentence stands when they agree; disagreements go to the reviewer. Claim files stay on your own hardware, never on community providers. Not served yet.","components":["llm-best","glm-wanted"],"hardware":"Your own hardware: 2x 96 GB cards for DeepSeek-V4-Flash plus 2x 96 GB for GLM-5.3-Flash, or one Mac Studio with 512 GB holding both 4-bit builds (156 + 165 GB, sizes from our Mac; not run together yet). Estimate.","quality_evidence":[{"metric":"eligibility and brief grounding","value":"not measured yet","source":null}],"latency_note":"not measured yet","in_hosted_demo":false,"receipt_coverage":"none","receipt_note":"On your own hardware its calls are attested by the box's key only: not a hosted model there, so no gateway receipts. Never sent to community providers.","hosting":"own-hardware"}],"alternates":[],"services":[{"name":"decosa-api","port":8445,"image":"${DECOSA_REGISTRY}/decosa-api:0.1.0","purpose":"Intake, the codes, the deadline rules, the quote checks, the recommendation rule, grounding, signing and the HTTP API (/appeal/*). No GPU. Binds 127.0.0.1 by default."},{"name":"decosa-llm","port":8000,"image":"${DECOSA_REGISTRY}/decosa-llm:0.1.0","purpose":"vLLM OpenAI endpoint for Qwen3.8-27B. Internal to the compose network."}],"tools":[{"name":"decosa grounding (vertical 17)","url":"https://decosa.ai/apps/grounding","license":"AGPL-3.0-or-later (decosa-api)","purpose":"Judges every brief sentence against the documents and the offer figures, and cites the span; imported, not copied."},{"name":"decosa numeric block","url":"https://decosa.ai/apps/sar-narrative-desk","license":"AGPL-3.0-or-later (decosa-api)","purpose":"Checks every amount, date and percentage in a brief sentence against the document lines it cites."},{"name":"decosa typed-judgment (vertical 24)","url":"https://decosa.ai/apps/typed-judgment","license":"AGPL-3.0-or-later (decosa-api)","purpose":"An advisory probability for the pre-November batching test (related to a similar condition), which the certified IDR entity decides."},{"name":"claims dates module (vertical 54)","url":"https://decosa.ai/apps/claims-conduct-pack","license":"AGPL-3.0-or-later (decosa-api)","purpose":"Business days and US federal holidays for every IDR clock; imported."},{"name":"decosa record (vertical 07) and POST /record/verify","url":"https://decosa.ai/apps/record","license":"AGPL-3.0-or-later (decosa-api)","purpose":"The hash chain and the Ed25519-signed packet; anyone can re-check it."},{"name":"eCFR: 45 CFR 149.510 (current and as in force on 1 May 2026), 149.420","url":"https://www.ecfr.gov/current/title-45/section-149.510","license":"public law","purpose":"The eligibility rules and clocks, quoted in /idr/info with the date read and whether they apply yet."},{"name":"Federal Register: 91 FR 33900 (4 Jun 2026) and 91 FR 55462 (28 Aug 2026)","url":"https://www.federalregister.gov/documents/2026/06/04/2026-11140/federal-independent-dispute-resolution-operations","license":"US government work (public domain)","purpose":"The IDR operations final rules and their staged applicability dates."},{"name":"CMS No Surprises guidance, state applicability chart and notices","url":"https://www.cms.gov/nosurprises/policies-and-resources/overview-of-rules-fact-sheets","license":"US government work (public domain)","purpose":"Batching guidance after TMA IV, the state-law chart, the 2026 implementation timeline and the batching notice."},{"name":"Fifth Circuit opinions in TMA II (No. 23-40217) and TMA III en banc (No. 23-40605)","url":"https://www.ca5.uscourts.gov/opinions/pub/23/23-40605-CV1.pdf","license":"public court records","purpose":"How the QPA is weighed and calculated; cited with dates."}],"hardware":[{"tier":"1x RTX PRO 6000 Blackwell 96 GB","fits":true,"notes":"Measured: the hosted demo's Qwen3.8-27B runs on one of these cards on our server."},{"tier":"1x L40S / RTX 6000 Ada 48 GB","fits":null,"notes":"Not measured. FP8 Qwen3.8-27B with a shorter context, or Gemma 4 26B A4B (lite)."},{"tier":"CPU only","fits":true,"notes":"The clocks (POST /idr/clock), the eligibility screen from structured facts (POST /idr/screen), the signed packet and verification need no GPU; reading documents and drafting need the model."}],"latency":[{"lane":"screen from documents (one model call), busy shared gateway","typical_ms":6200,"source":"decosa-api docs/evals/nsa-idr-packet.md, test median on our server 2026-09-27 (max 12.7 s), gateway route"},{"lane":"full packet with a brief, busy shared gateway","typical_ms":52100,"source":"measured on our server 2026-09-27: median of 7 runs of the three eligible samples (30 to 98 s; about 15 to 23 model calls), gateway route"},{"lane":"full packet with a brief, self-hosted direct route","typical_ms":20000,"source":"measured on our server 2026-09-27, self-host sandbox, er-anesthesia-pa (23 model calls)"},{"lane":"clocks and screen from structured facts","typical_ms":50,"source":"estimate: no model call"}],"benchmark":{"title":"Does it catch the disputes that should not be filed?","intro":"91 synthetic disputes from a generator with a structured truth: 40 eligible (24 of them traps that look ineligible) and 51 planted ineligible, 3 of each of 17 kinds. The gold clocks come from a separate implementation. In the documents run the model reads every fact from EOB and notice text with distractor dates; a 61-case test split was fixed before any run and run once.","rows":[{"label":"Held-out test, verdict right from documents","value":"61 of 61","detail":"32 ineligible caught on the planted check, 29 eligible passed"},{"label":"Facts read right from documents","value":"496 of 497","detail":"test; the miss read an issue date as the receipt date"},{"label":"Planted unsupported brief sentences removed","value":"25 of 25","detail":"and 22 of 22 supported sentences kept"},{"label":"Cost","value":"about $0.001 per screen, $0.02 per packet","detail":"1,662 tokens (1 call) and 52,263 tokens (23 calls) on the samples, gateway list price"}],"points":[{"heading":"What it does not show","text":"The documents are templated synthetic text with one fact per line; real 835 remittances, scanned EOBs and letters are much harder to read. The same author wrote the cases and the rules, so a perfect rules score shows the code matches that reading, not that the reading is right. Check it on your own closed disputes before relying on it."},{"heading":"Where the rules are still moving","text":"The 2026 final rule's new open negotiation and initiation steps apply only after the Departments announce each IDR Gateway function; the batching changes apply to negotiations starting on or after 1 Nov 2026. Every check shows which text it applies and when it was read."}],"source":"decosa-api docs/evals/nsa-idr-packet.md, 27 Sep 2026"},"notes":[]},"buyer_facts":[{"label":"What it gives you","value":"An eligibility screen (likely eligible, likely ineligible or needs review) with each check, its dated rule and the business-day arithmetic; the claim facts with quotes; the factor evidence; the offer as a dollar amount and a percentage of the QPA; a checked draft brief when nothing fails; a Markdown packet and a signed record."},{"label":"What it does not do","value":"It does not file in the IDR portal, predict or promise an outcome, recompute or audit a QPA, read state statutes (it uses CMS's chart and says when to check the state's letter), or decide the similar-condition batching test, which is the certified IDR entity's call. Scanned EOBs need OCR first."},{"label":"Data retention","value":"Nothing kept on the server. Documents and packets live in memory for the request; logs carry counts only. You keep the signed packet with the claim."},{"label":"What leaves the box (hosted demo)","value":"The documents go to Qwen3.8-27B through the Decosa API, whose receipts hold hashes, not text. Self-hosted, nothing leaves. The hosted demo is for synthetic disputes only."},{"label":"Model calls per run","value":"Screen mode: one call. Full packet: one fact read, one factor-evidence call, one brief and one grounding call per brief sentence, about 15 to 23 calls on the samples. The clocks and a screen from structured facts need no model."},{"label":"Typical run cost","value":"A fraction of a cent at the gateway list price for a screen from documents; a few cents for the emergency anesthesia packet with its brief. Each run shows its own measured cost."},{"label":"Rules and dates","value":"45 CFR 149.510 read on 27 Sep 2026 with the staged applicability of the 2026 final rule: $15 fee from 11 Jun 2026, new batching rules for negotiations from 1 Nov 2026, new portal steps only after each is announced. Plans and providers use the same screen."}],"data_handling":{"page":"/data#nsa-idr-packet","self_host":{"level":"confidential","leaves":"nothing","summary":"Runs on your machine; nothing is sent to Decosa or a third party by default."},"hosted":{"level":"operator-processed","demo_only":true,"summary":"Hosted demo on sample or public data only; self-host for real data.","gpus":"operator-contracted","third_parties":[],"retention":"Nothing kept on the server. Documents and packets live in memory for the request; logs carry counts only. You keep the signed packet with the claim.","used_for_training":false,"encrypted_while_processed":false},"sealed_tier":{"applies":false,"note":"The sealed tier (raw chat only, never use-case pipelines) is paused at launch (/docs/sealed-tier)."},"external_calls":[]},"console":{"href":"/clinics/nsa-idr-packet","input":"idr","lanes":[{"id":"screen","title":"Eligibility screen","kind":"list"},{"id":"clocks","title":"Business-day clocks","kind":"list"},{"id":"facts","title":"Facts read from the documents","kind":"list"},{"id":"evidence","title":"Evidence by factor","kind":"list"},{"id":"brief","title":"Offer brief","kind":"markdown"},{"id":"record","title":"Signed packet","kind":"json"}],"samples":[{"n":1,"id":"er-anesthesia-pa","title":"Er anesthesia pa","deep_link":"/clinics/nsa-idr-packet?sample=1&autorun=0"},{"n":2,"id":"radiology-batch-tx","title":"Radiology batch tx","deep_link":"/clinics/nsa-idr-packet?sample=2&autorun=0"},{"n":3,"id":"late-initiation-az","title":"Late initiation az","deep_link":"/clinics/nsa-idr-packet?sample=3&autorun=0"},{"n":4,"id":"ny-state-law","title":"Ny state law","deep_link":"/clinics/nsa-idr-packet?sample=4&autorun=0"},{"n":5,"id":"plan-consent-defense","title":"Plan consent defense","deep_link":"/clinics/nsa-idr-packet?sample=5&autorun=0"},{"n":6,"id":"plan-offer-er-co","title":"Plan offer er co","deep_link":"/clinics/nsa-idr-packet?sample=6&autorun=0"}],"deep_link_params":{"sample":"1-based index into samples, or a sample id","autorun":"1 = start the run once the sample is loaded; 0 (default) = only preselect","reduce-motion":"1 = turn off animations"}},"api":{"base":"https://api.decosa.ai","contract":"/api/contract.json","contract_markdown":"/api/contract.md","reference":"/docs/api","keys":"/account/keys"},"prompts":{"hosted":"/prompts/nsa-idr-packet-hosted.md","selfhost":"/prompts/nsa-idr-packet-selfhost.md","assemble":"/prompts/nsa-idr-packet-assemble.md","mac":null},"rehearsal":{"bundle":"/samples/nsa-idr-packet.zip","bundle_url":"https://decosa.ai/samples/nsa-idr-packet.zip","folder":"/samples/nsa-idr-packet/","expected":"/samples/nsa-idr-packet/expected.json","files":["/samples/nsa-idr-packet/expected.json","/samples/nsa-idr-packet/inputs/anesthesia-documents.json","/samples/nsa-idr-packet/inputs/late-documents.json"],"bytes":4549,"checks":["the IDR window opens on business day 31 of open negotiation, 6 Oct 2026 (no model)","and closes on business day 34, 9 Oct 2026","a self-insured plan that opted into New Jersey's law fails the state-law check (no model)","the eligible dispute is screened likely eligible from its documents","the QPA is read from the EOB with its quote","the offer is expressed as a percentage of the QPA","the billed-charges line is left out as a prohibited factor","a brief is drafted","and it does not mention Medicare rates or billed charges","the signed packet verifies","a packet whose verdict was changed no longer verifies","the late dispute is screened likely ineligible","on the initiation check","and no brief is drafted","every model call has a signed receipt"],"licence":"Synthetic (CC0): invented providers, plans, patients and figures (scripts/idr_samples.py). Part of decosa-api, AGPL-3.0-or-later.","about":"Two synthetic out-of-network disputes. The first (Pennsylvania, fully insured plan, emergency anesthesia) had its open negotiation notice sent on 24 Aug 2026, so the 4-business-day IDR window is 6 to 9 Oct 2026 (Labor Day skipped). The packet must read the facts from the EOB with quotes, screen it likely eligible, express the $2,350.00 offer as 198.48% of the $1,184.00 QPA, leave out the billed-charges, Medicare and FAIR Health lines (factors the arbiter may not consider), draft a brief, and seal a signed record that fails once changed. The second (Arizona) was initiated on 20 Aug 2026 after its window closed on 18 Aug: the screen must find it likely ineligible on the initiation check, from the documents alone.","run":{"containers":"docker compose exec api python scripts/rehearse.py nsa-idr-packet","checkout":"python scripts/rehearse.py nsa-idr-packet --bundle nsa-idr-packet.zip --base-url http://127.0.0.1:8445","mac":".venv/bin/python scripts/rehearse.py nsa-idr-packet"},"guidance":"Set up with a coding agent (we recommend Claude Code with Claude Opus 5.5; any capable coding agent works) on mock data only, run the rehearsal until every check passes, then run your own data locally yourself. Never give the agent real data during setup."},"hardware_fit":{"check":"/self-host/hardware?use=nsa-idr-packet","data":"/api/hardware.json","tiers":[{"id":"lite","gpu_gb":40,"basis":"estimate","unknown":[]},{"id":"standard","gpu_gb":57.6,"basis":"stack","unknown":[]},{"id":"best","gpu_gb":192,"basis":"stack","unknown":[]},{"id":"wanted","gpu_gb":384,"basis":"estimate","unknown":[]}],"mac":null},"links":{"page":"/clinics/nsa-idr-packet","json":"/use-cases/nsa-idr-packet.json","metrics":"/metrics/nsa-idr-packet","console":"/clinics/nsa-idr-packet","console_sample":"/clinics/nsa-idr-packet?sample=1&autorun=0","stack":"/clinics/nsa-idr-packet#stack","try_live":"/clinics/nsa-idr-packet","watch":"/clinics/nsa-idr-packet","build":"/clinics/nsa-idr-packet#build","self_host":"/clinics/nsa-idr-packet#self-host","prompts":{"hosted":"/prompts/nsa-idr-packet-hosted.md","selfhost":"/prompts/nsa-idr-packet-selfhost.md","assemble":"/prompts/nsa-idr-packet-assemble.md","mac":null}}}